Major Healthcare Reforms in the US


Over the decades, the US has undergone various healthcare reforms on healthcare coverage and the underlying cost. Recent debates have questioned whether the US healthcare should be shaped by the government, private entity competition, or forces within the healthcare market. The Republicans argue that healthcare should be shaped by a free market, while the Democrats have maintained that government involvement in healthcare would ensure that the industry works efficiently. Candidates from the republicans and the democrats have endlessly spearheaded increased political debates on health and healthcare, with each introducing other reforms across the history of the united states from 1945 to 2019.

13th August 1946

After the Second World War, Roosevelt in the New Deal programs had failed to settle some of the prevailing healthcare problems, including access to healthcare services. In 13th August 1946, President Truman signed the Hospital Survey and Construction Act of 1946 (Iglehart, 2018) which led to modernizing hospitals and increasing the number of hospitals. The law saw more funds and grants directed to modernize and build more hospitals, leading to a rapid increase in hospitals.

30th July 1965

In his Great Society ideology, John proposed various social reforms though constantly under opposition from the Republicans and the AMA. John introduced the Medicare and Medicaid act which was signed to law on 30th July 1965. The bill brought reforms in social security to cover individuals of 65 years and above, the disabled, the blind, and the poor (Schimmel, 2016). The reforms further expanded healthcare coverage to services provided by physicians, home care providers, hospitals, and nursing facilities.

1st July 1988

The Reagan administration sought to cut deficit spending and excessive government borrowing to ensure efficiency within the healthcare sector. As a result, President Reagan introduced the Medicare catastrophic coverage acts of 1988 which was signed into law in 1st July 1988 Lavanty (2018). The legislation saw expansion of Medicare benefits to cover outpatient drugs, slightly expanded payments for long-term care, and limits out-of-pocket co-pays to physicians and hospitals.

8th December 2003

Initially focused on managing war on terror inside and outside, the US president George W. Bush brought some of the most widespread healthcare cover reforms. According to Jooste (2016), the Medicare Drug Improvement and Modernization act of 2003 introduced by Bush administration was passed by Republicans in both houses. The December 8th 2003 act ensured prescription drug coverage benefits and the establishment of Medicare part D.

23rd March 2010

Obama prioritized healthcare coverage issues by aiming to reduce the cost and ensure coverage for all Americans. In 23rd March 2010, Obama signed the Patient Protection and Affordable Care Act (PPACA). The law further saw the US Supreme court rule; Medicaid expansion requiring all states to expand Medicaid coverage to all individuals with incomes up to 133% of the federal poverty level. The PPAACA to ensure large employers offer health coverage to their employees. The PPAACA ensures all citizens enroll under health coverage either through federal, state, or personal plans.

Why Health and Healthcare are Politically Charged and Polarizing

The heightening cost of access to healthcare and prescription drugs has become one of the most crucial matters for patients, politicians, and physicians. Most US citizens have expressed deep concern about the effect of healthcare on household financial capabilities. At the same time, physicians through the AMA code of medical ethics are encouraged to advocate for reforms and government laws related to healthcare. Unfortunately, due to the issue’s sensitivity to each party, debates on healthcare remain highly politically charged and polarizing.


Different reforms have been rolled regarding health insurance coverage through private insurers, government, employer-mandated health cover, and federal subsidies. Grassroots campaigns, divineness, and congressional fights have characterized the healthcare reforms. Congress has played its part in nullifying reforms that are not deemed public interest and approved reforms seen as popular and workable. Nevertheless, the already enacted reforms have proven critical in improving the quality of life of US citizens. Though the nation has not fully realized a more cost-efficient, highly accessible, and quality healthcare system, the progress has saved millions of lives.


Iglehart, J. K. (2018). The Challenging Quest to Improve Rural Health Care. New England Journal of Medicine, 378(5), 473–479. Web.

Jooste, R. (2016). Comparing the quality of end of life cancer care in the Medicare population prior to and after the enactment of the Medicare prescription drug, improvement and modernization act of 2003 (Doctoral dissertation, The University of Alabama at Birmingham).

Lavanty, D. F. (2018). “The Reagan Era of Politics and Healthcare.”. Political Aspects of Health Care, 53-64. Web.

Medicare prescription drug, improvement, and modernization act (2003). (n.d.). The SAGE Encyclopedia of Pharmacology and Society. Web.

Schimmel, N. (2016). Lyndon Baines Johnson’s Remarks at the Signing of the Medicare Bill, July 30, 1965 and Related Speeches. In Presidential Healthcare Reform Rhetoric (pp. 143-175). Palgrave Macmillan, Cham.

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